Why the study?
Does TAVI provide comparable long-term survival to SAVR in patients with symptomatic severe aortic stenosis?
Does TAVI provide comparable long-term survival to SAVR in patients with symptomatic severe aortic stenosis?
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This editorial challenges the 2021 ESC/EACTS guidelines, arguing that current evidence does not support equipoise in long-term survival between TAVI and SAVR for severe aortic stenosis.
The 2021 European Society of Cardiology/European Association of Cardio-Thoracic Surgery (ESC/EACTS) Guidelines for the Management of Valvular Heart Disease have summoned the consensus reached among the two most prestigious cardiology and cardiovascular surgery societies in Europe.1 The treatment of aortic stenosis (AS) should be accomplished aiming to restore long-term life expectancy and improve quality of life. For now, only the surgical aortic valve replacement (SAVR) is established to restore the prognosis of patients with symptomatic severe AS with long-term post-operative survival becoming comparable to an age- and sex-matched general population without AS in patients over 65 years old.2 The ESC/EACTS document assumes an equipoise between long-term survival of transcatheter aortic valve implantation (TAVI) and SAVR, which is unsupported by findings of most randomized controlled trials (RCTs), meta-analysis, and national databases. The PARTNER 2 cohort A trial has shown non-inferiority of TAVI at 2 years. Although no...
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Dayan et al. (2022) studied this question.
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